Bladder Oxidative Stress in Sleep Apnea Contributes to Detrusor Instability and Nocturia

Witthaus, Michael; Nipa, Farzana; Yang, Jinghua; Li, Yedan; Lerner, Lori B.; Azadzoi, Kazem M.

doi:10.1016/j.juro.2014.11.055

Cited by 54 publications

(39 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These conditions led to increased urinary frequency and involuntary bladder contractions. 25 Accordingly, CPAP therapy has been shown to improve OAB in patients with OSA. 26 …”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbance and Fatigue Are Associated With More Severe Urinary Incontinence and Overactive Bladder Symptoms

Vetter

Lai

2017

Urology

View full text Add to dashboard Cite

Objective To investigate the relationship between sleep disturbance, fatigue, and urinary incontinence (UI)/overactive bladder (OAB) symptoms among patients with OAB. Methods Patients who were diagnosed with overactive bladder (OAB) and age-matched control subjects without OAB were enrolled. Sleep disturbance and fatigue symptoms were assessed using the PROMIS short forms. UI/OAB symptoms were assessed using the ICIQ-UI, ICIQ-OAB, OAB-q, UDI-6, and IIQ-7 questionnaires. Psychosocial health (depression, anxiety, perceived stress level) was also assessed. Results OAB patients reported significantly greater sleep disturbance compared to controls (PROMIS 8b T-scores: 54.3 ± 10.3 vs. 43.8 ± 9.2). OAB patients also reported significantly greater fatigue compared to controls (PROMIS 7a T-scores: 54.7 ± 9.6 vs. 46.0 ± 6.4). After adjusting for nocturia, the differences in sleep disturbance between OAB and controls became insignificant (p=0.21) while the differences in fatigue between OAB and controls remained significant (p=0.014). Among OAB patients, there were positive correlations between sleep disturbance and the severity of OAB symptoms (ICIQ-OAB), poorer health-related quality of life (OAB-q QOL), the severity of urinary incontinence symptoms (ICIQ-UI), greater incontinence impact (IIQ-7) and urinary bother (UDI-6). Positive correlations were also observed between fatigue and worse UI/OAB symptoms and quality of life. Both sleep disturbance and fatigue were associated with poor psychosocial health (depression, anxiety, higher stress level) among OAB patients. Conclusions Sleep disturbance and fatigue are present in substantial percentages of OAB patients. Among OAB patients, sleep disturbance and fatigue were associated with more severe UI/OAB symptoms, worse health-related quality of life, and poorer psychosocial health.

show abstract

“…These conditions led to increased urinary frequency and involuntary bladder contractions. 25 Accordingly, CPAP therapy has been shown to improve OAB in patients with OSA. 26 …”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbance and Fatigue Are Associated With More Severe Urinary Incontinence and Overactive Bladder Symptoms

Vetter

Lai

2017

Urology

View full text Add to dashboard Cite

show abstract

“…Mediators of inflammation, including cytokines, chemokines, growth factors, and neuropeptides, have been shown to contribute to urinary bladder dysfunction and somatic sensitivity in animal models of cystitis and in the clinical syndrome of BPS/IC [ 3 , 4 ]. In addition, reactive oxygen species (ROS) and reactive nitrogen species (RNS) generated by inflammation result in oxidative stress and may contribute to urinary bladder dysfunction [ 5 , 6 ]. The role(s) that oxidants may have in inducing inflammation has been extensively studied in diverse experimental models [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Tempol on Cyclophosphamide‐Induced Oxidative Stress in Rat Micturition Reflexes

Gonzalez

Peterson

Malley

et al. 2015

The Scientific World Journal

View full text Add to dashboard Cite

We hypothesized that cyclophosphamide- (CYP-) induced cystitis results in oxidative stress and contributes to urinary bladder dysfunction. We determined (1) the expression of oxidative stress markers 3-nitrotyrosine (3-NT), reactive oxygen species (ROS)/reactive nitrogen species (RNS), inflammatory modulators, neuropeptides calcitonin gene-related peptide (CGRP), substance P (Sub P), and adenosine triphosphate (ATP) that contribute to the inflammatory process in the urinary tract and (2) the functional role of oxidative stress in urinary bladder dysfunction with an antioxidant, Tempol, (1 mM in drinking water) combined with conscious cystometry. In CYP-treated (4 hr or 48 hr; 150 mg/kg, i.p.) rats, ROS/RNS and 3-NT significantly (P ≤ 0.01) increased in urinary bladder. CYP treatment increased ATP, Sub P, and CGRP expression in the urinary bladder and cystometric fluid. In CYP-treated rats, Tempol significantly (P ≤ 0.01) increased bladder capacity and reduced voiding frequency compared to CYP-treated rats without Tempol. Tempol significantly (P ≤ 0.01) reduced ATP expression, 3-NT, and ROS/RNS expression in the urinary tract of CYP-treated rats. These studies demonstrate that reducing oxidative stress in CYP-induced cystitis improves urinary bladder function and reduces markers of oxidative stress and inflammation.

show abstract

“…Indeed, the study of physiological responses and adaptation to high-altitude hypoxia has always been a valid research possibility for a better understanding of the physiological and physiopathological mechanisms present in hypoxia-induced pathological conditions, e.g., in obstructive sleep apnea syndrome, diabetes, and aging, where one of the primary complications is bladder dysfunction (4,14,15,19,28).…”

Section: Discussionmentioning

confidence: 99%

“…As shown by Koritsiadis et al (17), the bladder response to chronic hypoxia is limited in time and might depend on the functional status of the detrusor. In addition, the hypoxic state, typical of obstructive sleep apnea, causes ultrastructural and pathophysiological changes, with bladder detrusor instability, bladder noncompliance, nocturia, and an increase in spontaneous contractions (28).…”

Section: Physiology Of Micturitionmentioning

confidence: 99%

The influence of altitude hypoxia on uroflowmetry parameters in women

Verratti

Paulesu

Pietrangelo

et al. 2016

American Journal of Physiology-Renal Physiology

View full text Add to dashboard Cite

There is scientific evidence to suggest a correlation between hypoxia and the physiology of micturition. During a Himalayan Scientific and Mountaineering Expedition, we performed tests to investigate the functional interactions between altitude hypoxia and uroflowmetry parameters in women. The tests were carried out in seven women (36.3 ± 7.1 yr) from normoxic [1,340 meters above sea level (m a.s.l.)] to hypoxic conditions (up to 5,050 m a.s.l.) and during the return descent. The following measures were determined: uroflowmetry parameters and saturation of peripheral oxygen (SpO2 ). As expected, SpO2 decreased from 97.7 to 77.8% with increasing altitude. Micturition flow time, flow volume, and voiding time increased with altitude (P < 0.04 for all), indicating a negative correlation with SpO2 In conclusion, in young adult women, micturition physiological parameters were affected during adaptation to hypoxia; the correlation with SpO2 strongly suggests a role of hypoxia in these changes. These data could help to support the design of new strategies for both prevention and medical treatment. An example of the latter might be hyperbaric oxygen therapy, which in some studies has proved able to reduce the symptoms in patients with hypoxic bladder.

show abstract

Bladder Oxidative Stress in Sleep Apnea Contributes to Detrusor Instability and Nocturia

Cited by 54 publications

References 28 publications

Sleep Disturbance and Fatigue Are Associated With More Severe Urinary Incontinence and Overactive Bladder Symptoms

Sleep Disturbance and Fatigue Are Associated With More Severe Urinary Incontinence and Overactive Bladder Symptoms

The Effects of Tempol on Cyclophosphamide‐Induced Oxidative Stress in Rat Micturition Reflexes

The influence of altitude hypoxia on uroflowmetry parameters in women

Contact Info

Product

Resources

About